CN104254289A - Occlusive devices - Google Patents

Occlusive devices Download PDF

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Publication number
CN104254289A
CN104254289A CN201380019992.6A CN201380019992A CN104254289A CN 104254289 A CN104254289 A CN 104254289A CN 201380019992 A CN201380019992 A CN 201380019992A CN 104254289 A CN104254289 A CN 104254289A
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CN
China
Prior art keywords
aneurysm
proximal section
coil
diameter
section
Prior art date
Legal status (The legal status is an assumption and is not a legal conclusion. Google has not performed a legal analysis and makes no representation as to the accuracy of the status listed.)
Granted
Application number
CN201380019992.6A
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Chinese (zh)
Other versions
CN104254289B (en
Inventor
M·莫莱
M·L·洛索多
A·内格斯瓦兰
S·格里芬
J·戴维森
Current Assignee (The listed assignees may be inaccurate. Google has not performed a legal analysis and makes no representation or warranty as to the accuracy of the list.)
Nellcor Puritan Bennett LLC
Covidien LP
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Nellcor Puritan Bennett LLC
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Publication of CN104254289A publication Critical patent/CN104254289A/en
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Classifications

    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/12—Surgical instruments, devices or methods, e.g. tourniquets for ligaturing or otherwise compressing tubular parts of the body, e.g. blood vessels, umbilical cord
    • A61B17/12022—Occluding by internal devices, e.g. balloons or releasable wires
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/12—Surgical instruments, devices or methods, e.g. tourniquets for ligaturing or otherwise compressing tubular parts of the body, e.g. blood vessels, umbilical cord
    • A61B17/12022—Occluding by internal devices, e.g. balloons or releasable wires
    • A61B17/12099—Occluding by internal devices, e.g. balloons or releasable wires characterised by the location of the occluder
    • A61B17/12109—Occluding by internal devices, e.g. balloons or releasable wires characterised by the location of the occluder in a blood vessel
    • A61B17/12113—Occluding by internal devices, e.g. balloons or releasable wires characterised by the location of the occluder in a blood vessel within an aneurysm
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/12—Surgical instruments, devices or methods, e.g. tourniquets for ligaturing or otherwise compressing tubular parts of the body, e.g. blood vessels, umbilical cord
    • A61B17/12022—Occluding by internal devices, e.g. balloons or releasable wires
    • A61B17/12131—Occluding by internal devices, e.g. balloons or releasable wires characterised by the type of occluding device
    • A61B17/1214—Coils or wires
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/12—Surgical instruments, devices or methods, e.g. tourniquets for ligaturing or otherwise compressing tubular parts of the body, e.g. blood vessels, umbilical cord
    • A61B17/12022—Occluding by internal devices, e.g. balloons or releasable wires
    • A61B17/12131—Occluding by internal devices, e.g. balloons or releasable wires characterised by the type of occluding device
    • A61B17/1214—Coils or wires
    • A61B17/1215—Coils or wires comprising additional materials, e.g. thrombogenic, having filaments, having fibers, being coated
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/12—Surgical instruments, devices or methods, e.g. tourniquets for ligaturing or otherwise compressing tubular parts of the body, e.g. blood vessels, umbilical cord
    • A61B17/12022—Occluding by internal devices, e.g. balloons or releasable wires
    • A61B17/12027—Type of occlusion
    • A61B17/12031—Type of occlusion complete occlusion
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/12—Surgical instruments, devices or methods, e.g. tourniquets for ligaturing or otherwise compressing tubular parts of the body, e.g. blood vessels, umbilical cord
    • A61B17/12022—Occluding by internal devices, e.g. balloons or releasable wires
    • A61B17/12099—Occluding by internal devices, e.g. balloons or releasable wires characterised by the location of the occluder
    • A61B17/12109—Occluding by internal devices, e.g. balloons or releasable wires characterised by the location of the occluder in a blood vessel
    • A61B17/12113—Occluding by internal devices, e.g. balloons or releasable wires characterised by the location of the occluder in a blood vessel within an aneurysm
    • A61B17/12118—Occluding by internal devices, e.g. balloons or releasable wires characterised by the location of the occluder in a blood vessel within an aneurysm for positioning in conjunction with a stent
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/12—Surgical instruments, devices or methods, e.g. tourniquets for ligaturing or otherwise compressing tubular parts of the body, e.g. blood vessels, umbilical cord
    • A61B17/12022—Occluding by internal devices, e.g. balloons or releasable wires
    • A61B17/12131—Occluding by internal devices, e.g. balloons or releasable wires characterised by the type of occluding device
    • A61B17/1214—Coils or wires
    • A61B17/12145—Coils or wires having a pre-set deployed three-dimensional shape
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/12—Surgical instruments, devices or methods, e.g. tourniquets for ligaturing or otherwise compressing tubular parts of the body, e.g. blood vessels, umbilical cord
    • A61B17/12022—Occluding by internal devices, e.g. balloons or releasable wires
    • A61B17/12131—Occluding by internal devices, e.g. balloons or releasable wires characterised by the type of occluding device
    • A61B17/12168—Occluding by internal devices, e.g. balloons or releasable wires characterised by the type of occluding device having a mesh structure
    • A61B17/12172—Occluding by internal devices, e.g. balloons or releasable wires characterised by the type of occluding device having a mesh structure having a pre-set deployed three-dimensional shape
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/12—Surgical instruments, devices or methods, e.g. tourniquets for ligaturing or otherwise compressing tubular parts of the body, e.g. blood vessels, umbilical cord
    • A61B17/12022—Occluding by internal devices, e.g. balloons or releasable wires
    • A61B2017/1205—Introduction devices
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/12—Surgical instruments, devices or methods, e.g. tourniquets for ligaturing or otherwise compressing tubular parts of the body, e.g. blood vessels, umbilical cord
    • A61B17/12022—Occluding by internal devices, e.g. balloons or releasable wires
    • A61B2017/1205—Introduction devices
    • A61B2017/12054—Details concerning the detachment of the occluding device from the introduction device

Abstract

An aneurysm therapy system is provided that can include a catheter and an occlusive device. The catheter can have a lumen extending between proximal and distal ends thereof. The occlusive device can be disposed within the catheter lumen and configured to reside in the aneurysm to restrict fluid flow within the aneurysm. The device can have a distal section that includes a coil having an outer diameter, a coil length, and a coil flexibility. The device can also include a self-expanding braided proximal section. The braided proximal section can be configured to expand during advancement out of the distal end of the catheter, and the distal section can be configured to distribute, along at least a portion of the coil length, a force of the advancement along an aneurysm interior wall.

Description

Blocking device
Technical field
The disclosure relates to implantable device.More particularly, the disclosure relates to a kind of blocking device, and described blocking device can implanted Ink vessel transfusing and in certain embodiments for aneurysm treatment.
Background technology
Provide multiple embolization device for aneurysm treatment.Usually, the embolization device weaving ball embolization device, coil and other types operates by interrupting blood flow and forming thrombosis subsequently.
Summary of the invention
The supplementary features of technical theme and advantage will be listed in following description, and will distinguish one from the other in the middle part of description, or learn by practice technology theme.Structure by specifically noting in this description content of writing and embodiment and accompanying drawing realize and obtain by the advantage of described technical theme.
According to some embodiments, aneurysm treatment system and the aneurysmal method for the treatment of can be provided.Described system can comprise conduit and blocking device.The cavity that conduit can have near-end, far-end and extend between the proximal and distal ends.Blocking device can be disposed in cavity, and is configured to be placed in aneurysm and flows in aneurysm with limit fluid.
Blocking device can comprise the portions of proximal of distal section and self expansion.Distal section can comprise the coil with external diameter, loop length and coil flexible.And proximal section can have: (i) has the radial compression of the first diameter when being positioned in conveying cavity; (ii) there is when not retraining the radial expansion state of the Second bobbin diameter being greater than coil diameter; (iii) the fabric length of loop length is greater than; (iv) fabric being less than coil flexible on per unit length is flexible.
In certain embodiments, proximal section can be configured to be expert at conducting pipes far-end during expand, and distal section can be configured to the power of advancing of distributing at least partially along aneurysm inwall along loop length.
And in certain embodiments, blocking device optionally can be included in the transition zone between proximal section and distal section, described transition zone has flexibility flexible lower than coil flexible and fabric on per unit length.
Distal section can be configured to abut aneurysm inwall, to guide proximal section farthest when proximal section advances in aneurysm.Distal section can comprise bending far-end.Such as, the maximum curvature radius of distal section can be less than the maximum curvature radius of proximal section.
Distal section has the default 3D shape of secondary when can be configured under radial expansion state.In certain embodiments, proximal section can be included in the first sweep in the first plane and at the first out-of-plane second sweep.
Such as, in certain embodiments, distal section can comprise the Part I of the first default bending part and the distal section in the first bending part distally of presetting, and Part I roughly extends in the first plane.Distal section also can be included in the second bending part that the first bending part nearside is arranged.Can extend in the second plane being different from the first plane at the Part II of the distal section of the second bending part nearside.Distal section can also be included in the 3rd sweep that the first bending part distally is arranged.The Part III of the distal section in the 3rd bending part distally can extend in the 3rd plane being different from the second plane.
Fabric length can from about 50mm to about 150mm.In certain embodiments, fabric length can from about 70mm to about 130mm.And fabric length can from about 90mm to about 100mm.Fabric length also can be about 100mm.
Coil can be configured to have substantially invariable external diameter.And loop length can from about 20mm to about 80mm.In certain embodiments, loop length can from about 30mm to about 60mm.Loop length also can from about 35mm to about 50mm.And loop length can be about 40mm.
In certain embodiments, when proximal section is when carrying in cavity, the first diameter can be substantially identical with coil diameter.First diameter can from about 0.014 inch to about 0.034 inch.First diameter can from about 0.016 inch to about 0.027 inch.In certain embodiments, the first diameter can from about 0.017 inch to about 0.021 inch.Second bobbin diameter can be about 2 times to about 8 times of the first diameter.Second bobbin diameter can be about 2.4 times to about 7 times of the first diameter.And Second bobbin diameter can be about 2.8 times to about 5.8 times of the first diameter.
In certain embodiments, device can be configured to make the wall of proximal section comprise bias current hole dimension." bias current hole dimension " can refer to the average cell size (at least one section of device) in hole, and the average cell size in described hole is fully small enough to hinder or stop fluid to be exchanged by the hole of described section.
Device (such as, the at least proximal section of device) active section or bias current section can be had, described active section or bias current section have bias current hole dimension, now the size in the hole of described section be decided to be when tubular part location in the blood vessel and contiguous aneurysm time stop blood to be enough to cause thrombosis to the degree in aneurysm by wall flow and cure aneurysm.
Such as, when the hole in bias current section or active section has when device (such as, support) is in extended mode the average cell size being less than about 500 microns, bias current hole dimension can be realized.In certain embodiments, average cell size can be less than about 320 microns.And average cell size can from about 25 microns to about 350 microns.Average cell size also can from about 40 microns to about 200 microns.And in certain embodiments, average cell size can from about 60 microns to about 150 microns.In addition, average cell size can be about 120 microns.
Large average cell size within the scope of these can operate into and make fluid flow displacement, and causes thrombosis in the inner volume encapsulated in cavity or by wall.Described hole can have the hole dimension of constant.Described hole can have the average cell size using inscribed circle diameter to measure.
In addition, in certain embodiments, device (such as, support) can be provided with the porosity of scope in 10%-95%, can expansion fabric in the porosity of employing scope in 10%-95% to realize these effects.In certain embodiments, the porosity of scope in 30%-90% can be adopted to realize these effects.And, the porosity of scope in 50%-85% can be adopted to realize these effects.
System also can be included in extension in proximal section and be connected to the molded component of proximal section.Molded component can comprise thrombosed fiber.Molded component also can comprise spiral-shaped.
Such as, molded component can be connected to near-end and the far-end of distal section.Under compression, molded component can limit longitudinal length, and described longitudinal length is greater than the longitudinal length of distal section when distal section is in compressive state.And the near-end of distad section and far-end can be applied extending force by molded component.
Optionally, molded component can be connected to near-end and the far-end of distal section, and near-end and far-end are biased toward one another, to assist to expand distal section.
System also can be included in the transition zone between nearside and distal section.Transition zone can have flexibility flexible lower than coil flexible and fabric on per unit length.Transition zone also can comprise the tubulose or solid parts that nearside and distal section are interconnected.
Proximal section can comprise near-end and far-end, and the far-end of distal section can be closed.And near-end also can be closed.
In certain embodiments, distal section can comprise filament, and described filament is configured to produce heat when being exposed to nuclear magnetic resonance thus impel thrombosis.
In order to contribute to conveying and expansion, system can also comprise propelling movement wire rod, and described propelling movement wire rod is detachably connected to the near-end of blocking device.And system can comprise delivery sheath, described delivery sheath is configured to accommodating blocking device and is transported in aneurysm by blocking device.Delivery sheath is retractible relative to blocking device, expands in aneurysm to allow blocking device.
Some embodiments also can provide treatment aneurysmal method.Such as, clinician can locate in the contiguous aneurysm of endovascular conduit.Then clinician can make the distal section of blocking device advance from the far-end of conduit.Distal section can comprise the coil with loop length and coil diameter.The proximal section of device also by making the far-end of proximal section row conducting pipes, can be extended to the radial expansion state when not retraining with the Second bobbin diameter being greater than coil diameter from the radial compression when being positioned in conveying cavity with the first diameter by clinician.
And in certain embodiments, along with the far-end of proximal section row conducting pipes, distal section can along the power of advancing of distributing at least partially along aneurysm inwall of loop length.Proximal section can be included in flexibility per unit length being greater than distal section flexibility.
In some embodiments of described method, distal section is advanced can comprise aneurysm inwall is abutted with the sidewall of coil.
And described method also can comprise makes additional blocking device advance in aneurysm.Such as, additional blocking device can comprise at least one in the device of non-expanding coil or braiding.Additional blocking device also can have the diameter being less than proximal section diameter.
In certain embodiments, the proximal section of device can be positioned in aneurysm, to make the sections of proximal section extend across aneurysm mouth, discharges to stop attachment device.
Such as set forth technical theme according to following various aspect.Conveniently, the various examples of the various aspects of described technical theme describe with the fund of numbering (1,2,3, etc.).These are provided as example and can not restriction technologies themes.It is noted that any subordinate fund can be combined in any combination and be placed in corresponding stand-alone entry, such as, fund 1 or fund 5.Other funds can be shown by similar fashion.
Fund 1. 1 kinds of aneurysm treatment systems, comprising:
Conduit, its cavity that there is near-end, far-end and extend between the proximal and distal ends; With
Blocking device, it is arranged in cavity, and is configured to be placed in aneurysm and flows in aneurysm with limit fluid, and described blocking device comprises:
Distal section, it comprises the coil with external diameter, loop length and coil flexible; With
The proximal section of the braiding of self expansion, it has: (i) has the radial compression of the first diameter when being positioned in conveying cavity; (ii) there is when not retraining the radial expansion state of the Second bobbin diameter being greater than coil diameter; (iii) be greater than the fabric length of loop length, and (iv) is less than the fabric flexibility of coil flexible on per unit length;
Wherein, proximal section be configured to be expert at conducting pipes far-end during expand, and distal section is configured to the power of advancing of distributing at least partially along aneurysm inwall along loop length.
The system of fund 2. according to fund 1, wherein, coil outer diameter substantially constant.
The system of fund 3. according to fund 1, wherein, distal section is configured to abut aneurysm inwall, to guide proximal section farthest when proximal section advances in aneurysm.
The system of fund 4. according to fund 1, wherein, when proximal section is when carrying in cavity, the first diameter and coil diameter are substantially identical.
The system of fund 5. according to fund 1, wherein, distal section comprises bending far-end.
The system of fund 6. according to fund 1, wherein, the maximum curvature radius of distal section is less than the maximum curvature radius of proximal section.
The system of fund 7. according to fund 1, wherein, has the default 3D shape of secondary when proximal section is under radial expansion state.
The system of fund 8. according to fund 1, wherein, fabric length is from about 50mm to about 150mm.
The system of fund 9. according to fund 1, wherein, loop length is from about 30mm to about 40mm.
The system of fund 10. according to fund 1, wherein, Second bobbin diameter is about 2.8 times to about 5.8 times of the first diameter, and the first diameter is from about 0.017 inch and about 0.021 inch.
The system of fund 11. according to fund 1, wherein, proximal section is included in the first sweep in the first plane and at the first out-of-plane second sweep.
The system of fund 12. according to fund 1, wherein, the wall of proximal section comprises average cell size from the hole of about 25 microns to about 250 microns.
The system of fund 13. according to fund 1, is also included in proximal section and extends and be connected to the molded component of proximal section.
The system of fund 14. according to fund 1, is also included in the transition zone between nearside and distal section, and described transition zone has flexibility flexible lower than coil flexible and fabric on per unit length.
Fund 15. 1 kinds of blocking devices, comprising:
Distal section, it comprises the coil with outer cross-sectional dimension, loop length and coil flexible; With
The proximal section of the braiding of self expansion, it has: (i) has the radial compression of the first cross sectional dimensions when being positioned in conveying cavity; (ii) there is when not retraining the radial expansion state of the second cross sectional dimensions being greater than coil section size; (iii) the fabric length of loop length is greater than; (iv) fabric being less than coil flexible on per unit length is flexible; And
Wherein, device is configured to be placed in aneurysm and flows in aneurysm with limit fluid.
The device of fund 16. according to fund 15, wherein, fabric length is from about 50mm to about 150mm.
The device of fund 17. according to fund 15, wherein, loop length is from about 30mm to about 40mm.
The device of fund 18. according to fund 15, is also included in the transition zone between nearside and distal section, and described transition zone has flexibility flexible lower than coil flexible and fabric on per unit length.
The aneurysmal method of fund 19. 1 kinds treatment, described method comprises:
Will in the contiguous aneurysm location of endovascular conduit;
The distal section of blocking device is advanced from the far-end of conduit, and distal section comprises the coil with loop length and coil diameter;
By making the far-end of proximal section row conducting pipes, the proximal section of blocking device is extended to the radial expansion state when not retraining with the Second bobbin diameter being greater than coil diameter from the radial compression when being positioned in conveying cavity with the first diameter;
Wherein, along with the far-end of proximal section row conducting pipes, distal section is along the power of advancing of distributing at least partially along aneurysm inwall of loop length.
The method of fund 20. according to fund 19, wherein, proximal section is included in flexibility per unit length being greater than distal section flexibility.
The method of fund 21. according to fund 19, wherein, makes distal section advance to comprise aneurysm inwall is abutted with the sidewall of coil.
The method of fund 22. according to fund 19, also comprises and additional blocking device is advanced in aneurysm.
The method of fund 23. according to fund 22, wherein, additional blocking device comprises at least one in the device of non-expanding coil or braiding.
The method of fund 24. according to fund 22, wherein, additional blocking device comprises the diameter being less than proximal section diameter.
The method of fund 25. according to fund 22, wherein, proximal section is positioned in aneurysm, to make the sections of proximal section extend across aneurysm mouth, discharges to stop attachment device.
It should be understood that foregoing general illustrates and following detailed description is all exemplary and explanatory, and aim to provide further illustrating for this technical theme.
Accompanying drawing explanation
The various features of illustrative examples of the present invention are described below with reference to accompanying drawing.Illustrated embodiment is intended to set forth but and unrestricted the present invention.Described accompanying drawing comprises with figure below:
Fig. 1 illustrates and is not retraining the blocking device under configuration according to some embodiments.
Fig. 2 A illustrates the blocking device being pushed out Fig. 1 of the far-end of conduit according to some embodiments, and wherein end coil presents and do not retrain configuration.
Fig. 2 B illustrates the blocking device being pushed out the far-end of conduit according to some embodiments, and wherein end coil presents and do not retrain configuration, and fabric starts to manifest and diameter expansion.
Fig. 2 C illustrates the blocking device being pushed out the far-end of conduit according to some embodiments, and wherein end coil presents and do not retrain configuration and the three-dimensional that fabric starts to present diameter expansion does not retrain configuration.
Fig. 2 D illustrates the blocking device manifested completely from conduit according to some embodiments, and the three-dimensional that wherein fabric is in diameter expansion does not retrain configuration.
Fig. 3 A illustrates the far-end being pushed out conduit according to some embodiments and enters the blocking device of aneurysmal Fig. 1, and wherein end coil presents and do not retrain or semi-constrained configuration.
Fig. 3 B illustrates the far-end being pushed out conduit according to some embodiments and enters aneurysmal blocking device, and wherein end coil presents and do not retrain or semi-constrained configuration, and fabric starts to manifest and diameter expansion.
Fig. 3 C illustrates the far-end being pushed out conduit according to some embodiments and enters aneurysmal blocking device, and wherein end coil presents and do not retrain or semi-constrained configuration, and fabric continues to manifest and diameter expansion.
Fig. 3 D illustrates the far-end being pushed out conduit according to some embodiments and enters aneurysmal blocking device, and wherein end coil presents and do not retrain or semi-constrained configuration, and the three-dimensional that fabric starts to present diameter expansion does not retrain configuration.
Fig. 3 E illustrates and almost to launch completely according to the far-end from conduit of some embodiments and to enter aneurysmal blocking device, and wherein end coil presents and do not retrain or do not retrain configuration, and the three-dimensional that fabric is in diameter expansion does not retrain configuration.
Fig. 4 describes to be positioned in aneurysm and to lack the embodiment of the blocking device of end coil according to some embodiments.
Fig. 5 A, 5B and 5C are to be positioned in aneurysm and to have several views of another embodiment of the blocking device of fabric and end coil according to some embodiments.
Fig. 6 A, 6B and 6C are several views of another embodiment of blocking device according to some embodiments, and described blocking device is positioned in aneurysm, has fabric and does not have end coil.
Fig. 7 is the blocking device according to some embodiments.
Fig. 8 is another blocking device according to some embodiments.
Detailed description of the invention
In the following detailed description, in order to provide the understanding completely to this technical theme, many details are listed.It should be understood that this technical theme can when do not have in these details some put into practice.In other cases, intact structure and technology is not shown specifically so that not fuzzy technical theme.
And, although this description lists the detail of various embodiment, it should be understood that explanation is only schematic and should be interpreted as restricted by any way.In addition, although it should be understood that specific embodiment of the present invention can be disclosed with the background of aneurysm treatment or illustrate, these embodiments can be used in other obstruction treatments in vascular system.In addition, these embodiments and the various application of modification that may be readily appreciated by one skilled in the art also comprise by general conception described here.
According to an aspect of embodiments more disclosed herein, provide blocking device and using method thereof, described blocking device and using method thereof in obstructing arterial tumor ratio as only used conventional coil advantageously.Some embodiments can provide the volume larger than conventional coil, and this can allow to launch less device materials and tend to improve the accelerating of implanted device simultaneously.And some embodiments also can be handled at aneurysmal sack or intracavity more easily.Such as, described device can meet the interior shape of aneurysm cavity more easily.In addition, when aneurysm starts size reduction, the aspect of some embodiments allows described device to be out of shape, and can be compressed to make described device dimensionally or reduce, to promote to cure aneurysm, this is normally impossible when using conventional coil or other devices.
Fig. 1 depicts an embodiment of blocking device 100, and described blocking device is applicable to occluder space, such as aneurysm (comprising neuro-vascular aneurysms or intracranial aneurysm) or blood vessel or other hollow anatomical structures.Described blocking device 100 comprises proximal section 102, and described proximal section can comprise fabric that is extendible, generally tubular.Proximal section 102 can be self expansion, tends to present its extended mode to make proximal section in abandoned situation.Blocking device 100 also comprises distal section 104, and described distal section is connected to the far-end 110 of proximal section 102.Described distal section 104 is the not damaged end coils extended away from the far-end 110 of proximal section 102.Other suitable not damaged end structures (such as, the soft polymer elements distad extended) can replace described end coil to use.
Proximal section 102 can comprise the fabric with many strands (such as metal wire rod or polymer filaments), and described many strands are woven in together to form pipeline, and the sidewall of described pipeline is formed by weave yarn.Cavity extends in proximal section 102 along proximal section 102, and by sidewall around.In the proximal section 102 described in FIG, near-end and far-end 108,110 are all closed.But one or two in near-end or far-end 108,110 may be opened.Closing end is formed by crimping, welding etc. and other securing members or method.
In blocking device 100 shown in Figure 1, the fabric of proximal section 102 under its non-restrained condition (or under its semi-constrained state, such as in aneurysm) presents " three-dimensional " configuration.An example of this 3-d modelling is shown in Figure 1.This configuration is three-dimensional, because the central axial line of proximal section 102 or longitudinal axis are not substantially flat or substantially on a single plane.Replace ground, proximal section 102 forms the first bending or bending part 200 (see Fig. 1 and Fig. 2 D) in the longitudinal midpoint being approximately centered at proximal section 102.The feature of this first sweep 200 is a part for proximal section 102, and in a described part for proximal section, the central axial line of proximal section 102 is generally within the first plane.In the opposite end of the first sweep 200, the near-end of proximal section 102 and distal portions can bend and stretch out the first plane, lay respectively at the nearside of the first sweep 200 and second of distally and the 3rd bending part or sweep 202,204 to be formed.Second can extend along roughly the same direction away from the plane of the first sweep 200 with the 3rd sweep 202,204, or in opposite direction or otherwise different direction extend.
3-d modelling shown in Fig. 1 and 2 D can be considered to complex bend part or many plain bendings part, and described complex bend part or many plain bendings part are the 3-d modellings of a type that possible adopt in proximal section 102.Spherical 3-d modelling can by being wrapped in proximal section 102 in spherical axle and proximal section 102 described in thermal finalization and realizing.Spiral is the 3-d modelling of adoptable another type, and described proximal section is wrapped on cylindrical mandrel by thermal finalization proximal section 102 simultaneously and implements by it.
As previously mentioned, proximal section 102 can comprise extendible fabric, and such as, the fabric of self expandable, can present larger diameter along some or all of its length to make proximal section 102 when expanding.Therefore, when from restraint release, such as when being pushed out the far-end 138 of delivery conduit 140, proximal section 102 can present deployed configuration, in described deployed configuration, and proximal section 102 not only diameter expansion but also present 3-d modelling.
Comprise in proximal section 102 in some embodiment of fabric that may be useful in neuro-vascular aneurysms, fabric can have the diameter being approximately 1.5-2.5mm in its expanded state.Coil or distal section 104 can be configured to have substantially invariable external diameter, and can from about 0.20mm to about 3mm, from about 0.30mm to about 2.5mm, from about 0.50mm to about 2mm or from about 0.40mm to about 1.5mm, and be about 0.45mm in certain embodiments.
And, in certain embodiments, when proximal section is when carrying in cavity, proximal section 102 reduce diameter can with coil or distal section diameter substantially identical.Reducing diameter can from about 0.014 inch to about 0.034 inch.Reducing diameter can from about 0.016 inch to about 0.027 inch.In certain embodiments, reducing diameter can from about 0.017 inch to about 0.021 inch (this can contribute to being carried through the conduit of similar size).Expansion diameter can be about 2 times to about 8 times that reduce diameter.Expansion diameter can be about 2.4 times to about 7 times that reduce diameter.And expansion diameter can be about 2.8 times to about 5.8 times that reduce diameter.
But other diameters are also in the scope of the present disclosure.Such as, fabric can size be decided to be that diameter is aneurysmal diameter or Breadth Maximum about 1/1 to two/3rd, blocking device 100 will be placed in described aneurysm.This fabric should be preferably shorter than the minor diameter fabric being ready to use in similar application.
And coil or distal section length can from about 20mm to about 80mm.In certain embodiments, loop length can from about 30mm to about 60mm.Loop length also can from about 35mm to about 50mm.And loop length can be about 40mm.Fabric can have the ability (and also having the ability of extending when compressing from its extend type) shortened when expanding from its reduction length.
The blocking device that will use in above-mentioned neuro-vascular aneurysms can have fabric or proximal section, and described fabric or proximal section ought about long 40-180mm in an expanded state.Fabric or proximal length can from about 50mm to about 150mm.In certain embodiments, fabric length can from about 70mm to about 130mm.And fabric length can from about 90mm to about 100mm.In certain embodiments, fabric length also can be about 100mm.
Proximal section 102 can be configured to have thromboembolism characteristic, so that the blood flow in hindering the body space (such as, aneurysm) launching blocking device 100 wherein.The porosity of (expansion) proximal section 102 and/or average cell size can be chosen to be and make to hinder the degree of blood flow to be enough to make aneurysm or other body spaces form thrombosis.
In certain embodiments, in order to make to hinder the degree of blood flow to be enough to make aneurysm or other body spaces form thrombosis, hole can have the average cell size being less than or equal to about 500 microns.Hole can have the average cell size being less than or equal to about 320 microns.Hole can have the average cell size from about 50 microns to about 320 microns.Hole can have the hole dimension of constant.Hole can have the average cell size using inscribed circle diameter to measure.
Such as, the porosity of scope in 10%-90% and/or the average cell size of scope in 25-250 micron (inscribed circle diameter) can be adopted, to make to hinder the degree of blood flow to be enough to make aneurysm or other body spaces form thrombosis in the proximal section 102 of expansion.
As previously mentioned, proximal section 102 can comprise the fabric that can be constructed by metal wire rod or strand.Suitable metal comprises rustless steel (such as, 304V rustless steel), cobalt-nickel alloy, cobalt chromium or cobalt chromium nickel (such as, L605 cobalt chromium nickel, 35NLT cobalt chromium nickel, or MP35N cobalt chromium nickel) alloy, Nitinol, platinum or platinum-tungsten alloys.Can adopt biodegradable wire rod, it is formed by magnesium or its alloy, ferrum or ferroalloy or polymer (such as PLA or PGA) form.Fabric can be combined to form by above-mentioned wire rod, such as, by one group of cobalt alloy wire rod and one group of platinum tungsten yarn woven.In certain embodiments, the diameter of weave yarn can be the scope of about 0.0010 inch or diameter is 0.0008 to 0.0020 inch.Can adopt multiple different weave patterns, and a kind of possible pattern adopts 32 strands being woven into two times two layouts (one-over-two-under-two arrangement) on, picks per inch is 120.In one embodiment, fabric is constructed by 304V rustless steel strand completely.In another embodiment, the combination of L605, Nitinol and platinum tungsten wire rod is adopted.
Weave yarn can be monofilament, cable, cladding wires or analog.One or more in weave yarn can comprise hypotube, and described hypotube can comprise the micropore be formed in its sidewall.Absorbable rod and/or formed the material (comprising any material discussed herein) of thromboembolism can be positioned in the cavity of hypotube and expose into via micropore and environment blood with dissect form touch.
One or more in braiding filament material can be chosen to be the generation heat when being exposed to nuclear magnetic resonance.Such as, ferrum or martensitic stain less steel wire rod can be adopted in fabric.By using this fabric, keep the body space be treated of blocking device 100 or aneurysm can be exposed to MRI after the implantation.Fabric produces heat in response to MRI, and this promotes to form thrombosis then in aneurysm or body space.
The cavity of proximal section 102 can be empty or have space, shown in embodiment as described.This provides very large degree of freedom to proximal section 102, to expand during use, to shrink, to shorten or elongated.Alternatively, material can be positioned in cavity, all (such as, polymer and/or the absorbable fibres of thrombosed fiber in this way of described material, such as PLA or PGA fiber, they can be crimped or pile up) or hardware (such as coil or core wire).Can adopt core coil, such as platinum wire rod, described platinum wire rod has armature winding and roughly to pass through extension along the central axial line of proximal section 102.
Distal section 104 can comprise softness or not damaged end coil, and the far-end 110 of described softness or not damaged end coil proximally section 102 is approximately towards distal extension.Such as, distal section 104 can be flexible platinum tungsten coil, and described flexible platinum tungsten coil has roughly around the armature winding of the longitudinal axis orientation of blocking device 100.Distal section 104 can be included in wherein longitudinal extension to be used as core wire or the analog of resistance to elongation device.Distal section 104 has two dimensional configurations can not retrain (or semi-constrained) state at it under, the two-dimentional curved configuration such as shown in Fig. 1 and 2 A-2D.Alternatively, distal section 104 can not retraining/semi-constrained state time there is 3-d modelling.
When blocking device 100 insertosome space (such as aneurysm) is middle, distal section 104 can work as the flexible not damaged introducing portion acting on blocking device 100.As seen in figure 3 a, along with device is sent to aneurysm from conduit 140, first distal section 104 occurs.Due to the distal section 104 of flexible relative, the damage of aneurysm experience is minimized.Distal section 104 starts to present its bending semi-constrained configuration (Fig. 3 B), thus forms sweep, and the diameter of described sweep is slightly less than aneurysmal diameter.Then the distal section 104 launched is used as guiding piece, described guiding piece prevents proximal section 102 " heading on " on the horizon from clashing into aneurysm wall, thus contact with single point or concentrated area, as utilized sharp keen, sharp-pointed, hard and/or firm end or contact point realize.Then proximal section 102 can advance in aneurysm suitably can hurt aneurysm wall.
Blocking device 100 is utilized to treat the carrying out of an embodiment of the method for aneurysm 300 as follows.First, conduit 140 (such as microguide) carry tumor Ink vessel transfusing advance to aneurysm 300 position or close to aneurysmal position.Blocking device 100 is advanced (such as to distally in conduit cavity, via propelling movement wire rod, described propelling movement wire rod is connected to the near-end 108 of proximal section 102 removedly), distal section 104 guides proximal section 102, to occur and first enter aneurysm 300 (Fig. 3 A) to make distal section 104 from the far-end 138 of conduit 140.
Along with distal section 104 enters aneurysm 300, described distal section 104 can be caused and present it and do not retrain or semi-constrained configuration, the two-dimentional curved configuration such as shown in Fig. 3 A-3B.Proximal section 102 then row conducting pipes 140 far-end 138 and enter aneurysm 300.Along with proximal section 102 be expert at conducting pipes 140 far-end 138 during expansion, distal section 104 can be configured to the power of advancing of distributing at least partially along aneurysm inwall 302 along loop length.
Therefore proximal section 102 can be allowed to diameter expansion (and also shortening in certain embodiments) and present do not retrain or semi-constrained configuration, describedly not retrain or semi-constrained configuration can be 3-d modelling, any one in such as those 3-d modellings discussed herein.When blocking device 100 launches completely in aneurysm 300, expansion diameter, the 3-d modelling of described blocking device hinder the blood flow in aneurysm 300, thus cause thrombosis.Therefore, blocking device 100 makes aneurysm 300 form thrombosis and seals aneurysm not to be exposed to blood flow, thus reduces or eliminate the danger of breaking with massive hemorrhage.
In other embodiments of this method, that aneurysm 300 is that break, wide tumor neck, large-scale or huge aneurysm.When aneurysm 300 be break and/or there is wide tumor neck 304, described method also comprises and to prevent by allowing or cause proximal section 102 diameter expansion and/or present 3-d modelling blocking device 100 through fracture site or tumor neck 304.
Described method can also comprise the blocking device 100 of employing expansion as framework or filling device, and be transported to by additional blocking device in aneurysm 300, described additional blocking device can have the proximal section of expandable braid type described here or the non-expanding coil of standard.Described device 100 can stride across tumor neck 304, to prevent from self from forming hernia, and if other devices are also in implanted aneurysm, also prevents other devices from forming hernia.
In addition, blocking device can advantageously provide multiple intersection point and the apparatus surface region that stride across tumor neck 304 larger than other devices.As shown in Fig. 5 C and 6C roughly, when device 304 is expanded in aneurysm 300, proximal section 102 can be overlapping with self and distal section 104, to form multiple intersection point and than the conventional coil that may use otherwise, basket or other devices less and less gap.In addition, because portions of proximal 102 comprises the internal volume larger than the cavity size of conventional coil or cavity, simultaneously much smaller than the diameter of aneurysm 300, so overlapping and upset portions of proximal 102 can form the obvious less depression or volume that are separated by bias current layer in aneurysm 300 and throughout tumor neck 304 ground, described bias current layer can with than conventional coil, basket or other devices obviously faster speed promote to solidify, and more promote the endothelialization throughout tumor neck 304 than conventional coil, basket or other devices.
Described method can also comprise and to prevent by allowing or cause proximal section 102 diameter expansion and/or present 3-d modelling blocking device 100 through Aneurysmal neck 304.
When adopting propelling movement wire rod, pushing wire rod and can comprise distally hook, the eyelet that described distally shackle is formed around the proximal end being passed in blocking device 100.Other attachment components can be adopted, comprise the attachment component that those have medical science or electrolysis ability to dismantle.As the replacement scheme of transmission means, blocking device 100 can be written into the distal part of the cavity of delivery sheath, and described delivery sheath can be configured to be transported to therapentic part by larger conduit then.The delivery sheath with the blocking device 100 of prestrain advances to therapentic part through conduit 140, and blocking device 100 can launch from the far-end of delivery sheath via propelling movement wire rod or push rod.
As shown in Figure 7, in other embodiments of blocking device 100, internal part 350 can be disposed in the cavity of proximal section 102, roughly longitudinally extends along cavity.Internal part 350 can optionally proximally the near-end 108 of section 102 extend to its far-end 110.As shown in Figure 7, internal part 350 optionally can comprise molded component, the various embodiments of molded component will be discussed in further detail at this.Molded component 350 (or other forms of internal part) can comprise elongated monofilament or multifilament, the metal wire rod of all single strands in this way of described monofilament or polymer filaments, the bundle of described multifilament all be twisted together by the wire rod of single or multiple material and/or the filament in this way cable or elongated fabric or web structure that are formed or many that utilize clip or other suitable binder structure to keep together almost parallel filaments.
Molded component 350 can be adopted in the cavity of proximal section 102, with when shaping element 352 (such as, proximal section 102) is under its non-restrained condition, give proximal section 102 two dimension or 3-d modelling.Molded component 350 can be adopted to give any two dimension discussed herein or 3-d modelling or other suitable described configuration.That expects does not retrain configuration and by thermal finalization or otherwise can be worked in molded component 350.Molded component 350 can be adopted, wherein proximal section self not there is specific thermal finalization or otherwise preset do not retrain configuration, or proximal section has two dimension or three-dimensional does not retrain configuration.When only molded component 350 have default do not retrain configuration, proximal section can be impelled when discharging from delivery conduit 140 or entering aneurysm 300 to become two dimension for molded component 350 or three-dimensional does not retrain or semi-constrained configuration.Like this by proximal section 102 realize do not retrain configuration can roughly be similar in molded component 350 preset do not retrain configuration.
As replacement or the additional project of as discussed above two dimension or 3-d modelling, internal part or molded component 350 can be roughly spiral helicine, wherein, molded component 350 roughly coils around the central axial line of proximal section 102, and the radially-outer surface of molded component 350 abuts or the inner surface of close proximal section 102.This molded component 350 can be configured to self expand to the configuration of larger diameter in the cavity of proximal section 102, thus when the expansion acting on proximal section 102 is assisted, thus when the assembly 352 of molded component is such as from restraint release in delivery conduit 140, the assembly of described molded component tends to impel proximal section 102 to open towards the configuration of larger diameter.
When the assembly 352 of molded component is such as radially compressed in the cavity of delivery conduit 140, this molded component 350 also can present diameter and reduce and/or substantially straight configuration.This can be taken as the conveying configuration of the assembly 352 of proximal section 102 or molded component.In this conveying configuration, diameter reduces and/or substantially straight molded component 350 can be assisted as conveying by giving proximal section 102 columnar strength.When adopting this helical form molded component, the near-end of molded component and far-end can be connected to the near-end of proximal section 102 and far-end 108,110 respectively securely, and the longitudinal contraction/elongation characteristics of proximal section 102 and molded component can be mated, another is made to extend long or distortion to make expansion or one of them of shrinking in proximal section 102 or molded component to tend to.
In another is implemented, roughly spiral helicine internal part or molded component can be adopted, and described internal part or molded component are connected to the two ends 108,110 of proximal section 102 with as above discussing.But, internal part 350 can be configured to being elongated with slightly high speed than proximal section 102 by during radial constraint, to make that the assembly of molded component is inserted delivery conduit 140 cavity, molded component is elongated, this radial contraction configuration then forcing proximal section 102 to become elongated, this radial contraction configuration is than the more elongated and radial contraction when not having the active force of molded component.Therefore proximal section 102 is remained on the state of radial contraction by molded component during carrying.This reduce the friction between proximal section 102 and conduit 140, and the conveying of blocking device 100 is more prone to.
As replacement or the additional project of elongation discussed herein, proximal section 102 can by the more low profile of reversing in advance to be provided for carry.
Adopting internal part or the molded component 350 of relatively high columnar strength, and when the far-end of molded component 350 or a part are firmly connected to far-end 110 or a part for proximal section 102, molded component 350 can by being applied to the far-end 110 of proximal section 102 or a part by pointing to the longitudinal force in distally and being used to impel proximal section 102 to become diameter and reducing configuration.This can divide and realize by proximal extension such as when the assembly 352 of molded component is positioned in the cavity of delivery conduit 140 by manually pushing internal part or molded component 350 along distal direction.This makes proximal section 102 elongate then, reduces the diameter of proximal section in conduit 140 simultaneously, thus is easy to make proximal section 102 through conduit 140.
Internal part or molded component 350 can comprise one or more and preshaped Nitinol wire rod is as above discussed.The Nitinol of suitable form is a martensite Nitinol, and described martensite Nitinol can be used to provide relative interior parts or molded component 350.In addition, the molded component of Nitinol or martensite Nitinol (or other materials) can be adopted, described molded component being in or close to substantially straight during indoor temperature (and opposite elongate), and being in or close to pitch of the laps during human body temperature (and relatively shortening).This molded component can be used to keep proximal section 102 with radial contraction state during being carried through conduit cavity with as above discussing.
Internal part or molded component 350 can comprise wire rod, cable, fabric or analog, and (such as, polymer or elastomer) liner of wherein one or more flexible relative is arranged on described wire rod, cable, fabric or analog.Therefore, when the proximal section 102 of blocking device 100 is in the cavity of conduit 140, internal part 350 will present the configuration of relatively straight portrait orientation, and proximal section 102 will present the configuration of radial compression, wherein the inwall of proximal section and one or more gasket contacts.Therefore proximal section 102 is clamped between liner (pad size is decided to be and contributes to this clamping) and the inwall of conduit 140, and therefore internal part 350 is configured to be used as column or longitudinal force transferring element, can distad push blocking device 100 to make by such as the power pointing to distally being applied to blocking device 100 at near-end 108 place of proximal section 102 during carrying along conduit cavity.Distally power is delivered to liner along internal part 350, and is delivered to the proximal section 102 of distad advancing from liner.The inwall of conduit 140 contributes to being formed sufficient friction between proximal section 102 and liner, to make capablely to be delivered to proximal section 102 from liner.Internal part or molded component 350 adopt such liner, internal part 350 can be configured to do not retrain or semi-constrained time pitch of the laps become spiral or present certain other two dimension or 3D shape, and cause the inwall of liner and proximal section 102 to disengage thus.
As shown in Figure 8, device 100 also can comprise at least one transition zone 400 between nearside and distal section 102,104.Transition zone 400 can have flexibility flexible lower than coil flexible and fabric on per unit length.
When measuring flexible for any one in nearside, transition or distal section, described flexibility can be confirmed as following measured value: the bending strength of per unit length, the bending strength in whole length, the bending strength of section per unit length or the bending strength of section total length.Such as, traditional formula can be used to calculate bending strength: σ=(3PL)/(2wt 2), wherein P is normal force, and L is the length of bundle, and w is the width of bundle, and t is the thickness of bundle, and y is the flexure of load(ing) point.And, can rule of thumb determining bending strength by using the roughly bending strength of different sample and schematic calculation section, comprising use traditional formula: σ=E* ε.
Transition zone 400 also can comprise the tubulose or solid parts that nearside and distal section 102,104 are interconnected.Transition zone 400 can comprise one or more convergent parts.In certain embodiments, device 100 can comprise multiple transition zone between nearside and distal section 102,104.
In certain embodiments, transition zone 400 can limit the length that length is more than or equal to distal section 104.And the length of proximal section 102 also can be more than or equal to the length of distal section 104.Therefore, in mathematical relationship, the ratio of the length of distal section 104 and transitional region 400 and proximal section 102 can be expressed as: 1: >=1: >=1.
Therefore, transitional region 400 can limit the length that length is greater than distal section 104.And transition length can from about 30mm to about 120mm.In certain embodiments, transition length can from about 40mm to about 100mm.Transition length also can from about 50mm to about 80mm.And transition length can be about 60mm.
Before implantation, blocking device 100 can be cooled, such as, by sub-cooled.When being transported in the aneurysm or body space be treated, promotion is formed thrombosis by the low temperature of blocking device 100 in aneurysm or body space.As this replacement that cools in advance or additional project, the proximal section 102 of blocking device 100 or other parts can be coated or be stained with the material endothermically reacted with blood or other body fluid or material.When being transported in the aneurysm or body space be treated, reacting substance endothermically will react and makes contiguous blood or the cooling of other anatomical structures, promotes thus to form thrombosis in aneurysm or body space.As replacement or the additional project of above-mentioned cooling means, hypotube can be provided, described hypotube extends out from blocking device 100 to patient-proximate, and be used to coolant (such as refrigerated brine) to be transferred to implanted blocking device 100, lower the temperature to make device and/or surrounding anatomical structures and promote thrombosis.This hypotube can alternatively or additionally be used to other materials is transferred to implanted blocking device 100 (such as, being delivered in fabric cavity), and described other materials comprises embolism materials, such as microsphere or thromboembolism liquid.
As the alternative scheme of disclosed proximal section 102, the proximal section 102 for blocking device 100 can adopt knitmesh tubular structure.As another replacement scheme, proximal section 102 can comprise the pipeline replacing fabric or the cut of knitmesh pipe or the support of photoengraving or formed by one or more non-woven fiber, such as, be extruded or be otherwise combined together to form the long fibre of tubulose or flaky material.As another replacement scheme, the sacculus of the highly compatible of appropriate length and diameter can be used as proximal section 102, and described sacculus after being transported in the aneurysm or body space be treated by saline or other suitable fluid inflation.
Be used as the fabric of proximal section 102, fabric, support etc. to be capped by some or all along proximal section length of tubular polymer film.Film can have the hole be formed in wherein, to give the accelerating and/or resistance of aspiration level to blood flow.As replacement or the additional project of this film, can adopt in blocking device 100 or proximal section 102 thrombosed material as coating, additive or other, described thrombosed material is such as gold, platinum, platinumiridio or fibrin.When adopting fabric, the electric current (and any generation is accelerating) that the electric interactions of the point of intersection between weave yarn metal can be chosen to be and to make by the wire rod of different metal causes maximizes.
Although these inventive embodiments are open in the content of some embodiment, but it is understood to one skilled in the art that the present invention also prolongs and to other alternate embodiment and/or purposes of the present invention and their obvious amendment and equivalent except concrete disclosed embodiment.In addition, although be shown specifically and described several flexible program of the present invention, to those skilled in the art, based on present disclosure, other modifications within the scope of the present invention will become apparent.Also can be contemplated that, can various combination and sub-portfolio be made to the specific features of embodiment and aspect and still fall within the scope of the present invention.It should be understood that the various characteristic sum aspects of the disclosed embodiments can mutually combine or replace, to form the changing pattern of disclosed invention.
Claims (amendment according to treaty the 19th article)
1. an aneurysm treatment system, comprises the combination with lower component:
Conduit, the cavity that this conduit has near-end, far-end and extends between the proximal and distal ends; With
Blocking device, this blocking device is arranged in cavity, and is configured to be placed into be limited in the fluid flowing in aneurysm in aneurysm, and described blocking device comprises:
Distal section, this distal section comprises the coil with coil near-end, external diameter, loop length and coil flexible; With
The proximal section of the braiding of self expansion, this proximal section has the fabric far-end and cavity that are connected to coil near-end, without material in described cavity, described proximal section has: (i) has the radial compression of the first diameter when being positioned in conveying cavity; (ii) there is when not retraining the radial expansion state of the Second bobbin diameter being greater than coil diameter; (iii) the fabric length of loop length is greater than; (iv) fabric being less than coil flexible on per unit length is flexible;
Wherein, expand during proximal section is configured to outside the far-end advancing to conduit, and distal section is configured to the power of advancing of distributing at least partially along aneurysm inwall along loop length.
2. aneurysm treatment system according to claim 1, wherein, coil outer diameter substantially constant.
3. aneurysm treatment system according to claim 1, wherein, distal section is configured to abut aneurysm inwall, to guide proximal section farthest when proximal section advances in aneurysm.
4. aneurysm treatment system according to claim 1, wherein, when proximal section is when carrying in cavity, the first diameter and coil diameter are substantially identical.
5. aneurysm treatment system according to claim 1, wherein, distal section comprises bending far-end.
6. aneurysm treatment system according to claim 1, wherein, the maximum curvature radius of distal section is less than the maximum curvature radius of proximal section.
7. aneurysm treatment system according to claim 1, wherein, has the default 3D shape of secondary when proximal section is under radial expansion state.
8. aneurysm treatment system according to claim 1, wherein, fabric length is from about 50mm to about 150mm.
9. aneurysm treatment system according to claim 1, wherein, loop length is from about 30mm to about 40mm.
10. aneurysm treatment system according to claim 1, wherein, Second bobbin diameter is about 2.8 times to about 5.8 times of the first diameter, and the first diameter is from about 0.017 inch and about 0.021 inch.
11. aneurysm treatment systems according to claim 1, wherein, proximal section is included in the first sweep in the first plane and at the first out-of-plane second sweep.
12. aneurysm treatment systems according to claim 1, wherein, the wall of proximal section comprises average cell size from the hole of about 25 microns to about 250 microns.
13. aneurysm treatment systems according to claim 1, are also included in proximal section and extend and be connected to the molded component of proximal section.
14. aneurysm treatment systems according to claim 1, are also included in the transition zone between proximal section and distal section, and described transition zone has flexibility flexible lower than coil flexible and fabric on per unit length.
15. 1 kinds of blocking devices, comprising:
Distal section, this distal section comprises the coil with coil near-end, outer cross-sectional dimension, loop length and coil flexible; With
The proximal section of the braiding of self expansion, this proximal section has the fabric far-end and cavity that are connected to coil near-end, without material in described cavity, described proximal section has: (i) has the radial compression of the first cross sectional dimensions when being positioned in conveying cavity; (ii) there is when not retraining the radial expansion state of the second cross sectional dimensions being greater than coil section size; (iii) the fabric length of loop length is greater than; (iv) fabric being less than coil flexible on per unit length is flexible; And
Wherein, described blocking device is configured to be placed in aneurysm to be limited in the fluid flowing in aneurysm.
16. devices according to claim 15, wherein, fabric length is from about 50mm to about 150mm.
17. devices according to claim 15, wherein, loop length is from about 30mm to about 40mm.
18. devices according to claim 15, are also included in the transition zone between proximal section and distal section, and described transition zone has flexibility flexible lower than coil flexible and fabric on per unit length.
19. 1 kinds of aneurysmal methods for the treatment of, described method comprises:
Will in the contiguous aneurysm location of endovascular conduit;
The distal section of blocking device is advanced from the far-end of conduit, and distal section comprises the coil with coil near-end, loop length and coil diameter;
Advance to outside the far-end of conduit by making proximal section, the proximal section of blocking device is extended to the radial expansion state when not retraining with the Second bobbin diameter being greater than coil diameter from the radial compression when being positioned in conveying cavity with the first diameter, wherein, described proximal section has the fabric far-end and cavity that are connected to coil near-end, without material in described cavity;
Wherein, along with proximal section advances to outside the far-end of conduit, distal section is along the power of advancing of distributing at least partially along aneurysm inwall of loop length.
20. methods according to claim 19, wherein, proximal section is included in flexibility per unit length being greater than distal section flexibility.
21. methods according to claim 19, wherein, make distal section advance to comprise aneurysm inwall is abutted with the sidewall of coil.
22. methods according to claim 19, also comprise and additional blocking device are advanced in aneurysm.
23. methods according to claim 22, wherein, additional blocking device comprises at least one in the device of non-expanding coil or braiding.
24. methods according to claim 22, wherein, additional blocking device comprises the diameter being less than proximal section diameter.
25. methods according to claim 22, wherein, proximal section is positioned in aneurysm, to make the sections of proximal section extend across aneurysm mouth, discharges to stop attachment device.

Claims (25)

1. an aneurysm treatment system, comprises the combination with lower component:
Conduit, the cavity that this conduit has near-end, far-end and extends between the proximal and distal ends; With
Blocking device, this blocking device is arranged in cavity, and is configured to be placed into be limited in the fluid flowing in aneurysm in aneurysm, and described blocking device comprises:
Distal section, this distal section comprises the coil with external diameter, loop length and coil flexible; With
The proximal section of the braiding of self expansion, this proximal section has: (i) has the radial compression of the first diameter when being positioned in conveying cavity; (ii) there is when not retraining the radial expansion state of the Second bobbin diameter being greater than coil diameter; (iii) be greater than the fabric length of loop length, and (iv) is less than the fabric flexibility of coil flexible on per unit length;
Wherein, expand during proximal section is configured to outside the far-end advancing to conduit, and distal section is configured to the power of advancing of distributing at least partially along aneurysm inwall along loop length.
2. aneurysm treatment system according to claim 1, wherein, coil outer diameter substantially constant.
3. aneurysm treatment system according to claim 1, wherein, distal section is configured to abut aneurysm inwall, to guide proximal section farthest when proximal section advances in aneurysm.
4. aneurysm treatment system according to claim 1, wherein, when proximal section is when carrying in cavity, the first diameter and coil diameter are substantially identical.
5. aneurysm treatment system according to claim 1, wherein, distal section comprises bending far-end.
6. aneurysm treatment system according to claim 1, wherein, the maximum curvature radius of distal section is less than the maximum curvature radius of proximal section.
7. aneurysm treatment system according to claim 1, wherein, the default 3D shape of tool secondary when proximal section is under radial expansion state.
8. aneurysm treatment system according to claim 1, wherein, fabric length is from about 50mm to about 150mm.
9. aneurysm treatment system according to claim 1, wherein, loop length is from about 30mm to about 40mm.
10. aneurysm treatment system according to claim 1, wherein, Second bobbin diameter is about 2.8 times to about 5.8 times of the first diameter, and the first diameter is from about 0.017 inch and about 0.021 inch.
11. aneurysm treatment systems according to claim 1, wherein, proximal section is included in the first sweep in the first plane and at the first out-of-plane second sweep.
12. aneurysm treatment systems according to claim 1, wherein, the wall of proximal section comprises average cell size from the hole of about 25 microns to about 250 microns.
13. aneurysm treatment systems according to claim 1, are also included in proximal section and extend and be connected to the molded component of proximal section.
14. aneurysm treatment systems according to claim 1, are also included in the transition zone between proximal section and distal section, and described transition zone has flexibility flexible lower than coil flexible and fabric on per unit length.
15. 1 kinds of blocking devices, comprising:
Distal section, this distal section comprises the coil with outer cross-sectional dimension, loop length and coil flexible; With
The proximal section of the braiding of self expansion, it has: (i) has the radial compression of the first cross sectional dimensions when being positioned in conveying cavity; (ii) there is when not retraining the radial expansion state of the second cross sectional dimensions being greater than coil section size; (iii) the fabric length of loop length is greater than; (iv) fabric being less than coil flexible on per unit length is flexible; And
Wherein, described blocking device is configured to be placed in aneurysm to be limited in the fluid flowing in aneurysm.
16. blocking devices according to claim 15, wherein, fabric length is from about 50mm to about 150mm.
17. blocking devices according to claim 15, wherein, loop length is from about 30mm to about 40mm.
18. blocking devices according to claim 15, are also included in the transition zone between proximal section and distal section, and described transition zone has flexibility flexible lower than coil flexible and fabric on per unit length.
19. 1 kinds of aneurysmal methods for the treatment of, described method comprises:
Will in the contiguous aneurysm location of endovascular conduit;
The distal section of blocking device is advanced from the far-end of conduit, and distal section comprises the coil with loop length and coil diameter;
By making proximal section advance to outside the far-end of conduit, the proximal section of blocking device is extended to the radial expansion state when not retraining with the Second bobbin diameter being greater than coil diameter from the radial compression when being positioned in conveying cavity with the first diameter;
Wherein, along with proximal section advances to outside the far-end of conduit, distal section is along the power of advancing of distributing at least partially along aneurysm inwall of loop length.
20. methods according to claim 19, wherein, proximal section is included in flexibility per unit length being greater than distal section flexibility.
21. methods according to claim 19, wherein, make distal section advance to comprise aneurysm inwall is abutted with the sidewall of coil.
22. methods according to claim 19, also comprise and additional blocking device are advanced in aneurysm.
23. methods according to claim 22, wherein, additional blocking device comprises at least one in the device of non-expanding coil or braiding.
24. methods according to claim 22, wherein, additional blocking device comprises the diameter being less than proximal section diameter.
25. methods according to claim 22, wherein, proximal section is positioned in aneurysm, to make the sections of proximal section extend across aneurysm mouth, discharges to stop attachment device.
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